SARAH FULLER (LPC - 6401223002) – Professional Counselor, NPI 1477176907

SARAH FULLER (LPC - 6401223002) is a healthcare provider. based in Grand rapids, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC - 6401223002. They hold a License No. 6401223002 (MI). The NPI Number for SARAH FULLER (LPC - 6401223002) is 1477176907

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
SARAH FULLER (LPC - 6401223002)
NPI
1477176907
Phone
(616) 942-2110
Address
3300 36TH ST SE
Enumeration Date
19 May 2020
Last Update Date
7 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2318840028
Graduation Year
2020 (6 years ago)
PAC ID
4789124074
Group Practice PAC ID
7517498728
Professional Enrollment ID
I20240913000239
Address ID
MI496011859CA201XXSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:6State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for SARAH FULLER (LPC - 6401223002)

  • 3300 36TH ST SE

    GRAND RAPIDS, MI 495122810

    Phone: (616) 942-2110

    Type: Mailing

  • 2080 UNION AVE SE STE A

    GRAND RAPIDS, MI 495073247

    Phone:

    Type: Mailing

  • 201 N MITCHELL ST STE 204

    CADILLAC, MI 496011859

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240913000239IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49512)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517498728View full group profile
NameSpecialtyState
Mental Health CounselorMI
Mental Health CounselorMI
Clinical Social WorkerMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

What federal number belongs to SARAH FULLER (LPC - 6401223002)?
The federal identifier for SARAH FULLER (LPC - 6401223002) is NPI 1477176907.
Is SARAH FULLER (LPC - 6401223002)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does SARAH FULLER (LPC - 6401223002) treat or focus on?
Patients typically see SARAH FULLER (LPC - 6401223002) under the specialty Professional Counselor. Clinical services aligned with this taxonomy classification.
What location shows for SARAH FULLER (LPC - 6401223002)?
We surface Grand Rapids, Michigan for SARAH FULLER (LPC - 6401223002) based on available NPPES addresses.
How can I contact SARAH FULLER (LPC - 6401223002)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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